SINGLE PUREBRED MI-KI REGISTRATION APPLICATION
PLEASE
READ ALL THE INSTRUCTIONS ON THE BELOW BEFORE COMPLETEING THIS
APPLICATION.
PRINT ALL INFORMATION (except signature). USE BLACK INK AND
CAPITAL
LETTERS WHEN FILLING OUT THIS APPLICATION
Make all check
payable to ARBMR or American Rare Breed Mi-Ki Registry and
Mail to:
AMERICAN RARE BREED MI-KI REGISTRY
c/o Lawrie
Willis 139 Mill Street, Delano, Tennessee 37325
|
REGISTRATION FEE: $10.00 DO
NOT SEND CASH
|
Registered
Name of Mi-Ki
(The Registration
name is to be limited to 30 characters including spaces. The 30 characters does
not include
the Kennel Name of the Mi-Kis breeder. Skip a
box between words. Do not include titles.)
Sex: ________ Spay/Neuter:
___ Yes ___ No Color: ___________________________ DOB:
___/___/______ (Example: White, Black, and Blue Silver) (Example:
01/01/2006)
Whelping
Location: (City)________________________ (State)________ If
Whelping Location is unknown, indicate the Breeder’s name and phone number: ___________________________________________________________________________________________
UKC DNA #: Z_________ If
your Mi-Ki was not DNA’d through the UKC, indicate the following: DNA #: ____________
Name of Lab: __________________________ City:
_________________ State: _______ Phone: ________________________
IF THE ABOVE
MI-KI’S SIRE AND/OR DAM ARE NOT REGISTERED WITH
THE ARBMR, IT IS REQUIRED THAT YOU FURNISH A COLOR COPY OF THE SIRE AND/OR DAM’S
DNA CERTIFICATE (S). ANY BLACK AND WHITE COPIES OF THE
DNA CERTIFICATES WILL BE RETURNED AND WILL DELAY REGISTRATION. IT IS
REQUIRED THAT YOU FURNISH A BLACK AND WHITE COPY OF THE REGISTRATION
CERTIFICATE THAT YOU CURRENTLY HAVE FROM OTHER REGISTRIES.
Owner(s) Name:
____________________________________________________________________________________________
(Example: John
and/or Joanna Smith or John Smith)
Address: ____________________________________ City: _______________________ State: ______ Zip: ____________
Home Phone: (_____) ______ - ________ Best
time to call? ___________ Cell Phone: (_____) ______ - ________
Email Address:
_______________________________________________
Signature(s)
as appearing above: ____________________________________________ Date
of Signed: ____________ 20___
Instructions for Completing ARBMR's
Purebred Mi-Ki Registration Application
1.
Clearly, print or type ALL INFORMATION. If
we cannot read all information requested, the application will be returned to
you. This will delay your registration certificate.
2.
If the Mi-Ki is or has been registered with another Mi-Ki Organization,
Club, or Association, a copy of this Mi-Ki's registration certificate MUST accompany this application.
3. A color copy of this
Mi-Ki's DNA certificate MUST also accompany this
application.
4.
Mi-Kis eligible for
registration with the ARBMR MUST is registered
in owner’s name only. Co-ownership application’s ARE
NOT accepted.
5.
Failure to sign and date this application, incorrect fee, incorrect copy
of DNA certificate and a copy Registration certificate will result in delay of
processing registration.
6.
If the ARBMR finds, at any time, that the owner misrepresents any
information on this registration application, or misrepresents their Mi-Kis or
the Mi-Ki breed, this will be considered cause for cancellation and will result
in loss of all ARBMR privileges.
7.
If you have any questions regarding this registration application, please
contact Lawrie Willis at 423-263-0301 or send an e-mail message (include your phone number) to ARBMR@comcast.net.
Registration Application (7/7/2006)
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